Last night Cerner managed a major upgrade to its Community Works clients. As our brave employees huddled over their computers, validating the upgrade at 1:30 a.m. this morning, it occurred to me that we are a lucky crew to have selected the ASP model for our EHR solution.

Yes, sharing the domain can be frustrating when we request a change that impacts other clients in the shared space … but it is also nice when other clients have suggestions that benefit us.

Yes, it would be nice to have an IT department onsite to handle all this folderol and hoopla instead of our registration clerk, lab manager, financial manager and night nurse … but then we would have to recruit, pay and keep happy a highly skilled employee in a very rural area of the country.

Yes, frustration levels increase when changes are implemented in the domain … but then again, our software is up to date on Cerner’s dime, all the time. We don’t have to keep current on patches and updates to the system like we would if we had the software installed on our own servers.

We recently participated in our 21st reference event since going live January 2011. These events can be phone calls, emails or site visits from other health care organizations considering Cerner as their EHR partner. We answer questions, connect their employees with peer employees at Syringa, and share the good and the frustrating with them.

Syringa’s employees focus on providing quality patient care and service, so it is sometimes hard to see how far we have come on this journey. With HIMSS 6 and Stage 1 Meaningful Use Attestation under our belts, we are a model implementation; but now we have the basics under our belt, we strive for ways to better serve our patients.

Dare I mention our old friend, Alice in Through the Looking Glass? She spent some time with the White Queen – the Queen who practiced believing as many as six impossible things before breakfast. This Queen had a fantastic memory, one which roamed toward the past, but also into the future. She could remember things that had not happened yet, and found Alice’s memory “a poor sort that only works backward.”

If backward memory is experience, then forward memory is anticipation. We must anticipate what our patient’s need, the health care sector will require of us, and the economic factors that affect the bottom line.

This is where we are now. We have plenty of backward memory. It is time to move into forward memory mode: anticipating improved patient outcomes by making use of our EHR experience and information.